Fiscal Summary

NOT SIGNIFICANT

Bill Summary

Under present law, a physician assistant may perform selected medical services only in collaboration with a licensed physician. Collaboration requires active and continuous overview of the physician assistant's activities to ensure that the physician's directions and advice are in fact implemented, but does not require the continuous and constant physical presence of the collaborating physician. The range of services that may be provided by a physician assistant must be set forth in a written protocol, jointly developed by the collaborating physician and the physician assistant.

This bill instead specifies that:

(1) A physician assistant is authorized to treat, diagnose, or prescribe for an ailment or a physical injury to or deformity of another person within the physician assistant's scope of practice for which the physician assistant is trained, credentialed, privileged, or authorized to perform services;

(2) A physician assistant is authorized to perform procedures considered minor surgery under the conditions specified in the full text of this bill;

(3) The range of services that may be provided by a physician assistant with 6,000 or fewer hours of postgraduate clinical experience must be set forth in a protocol, jointly developed by the collaborating physician and the physician assistant. The full text of this bill specifies some considerations that must be addressed in a written protocol;

(4) A physician assistant with 6,000 or fewer hours of postgraduate clinical experience who changes practice settings to a different medical specialty must collaborate with a specific physician in that medical specialty for at least six months;

(5) The range of services that may be provided by a physician assistant with more than 6,000 hours of postgraduate clinical experience who practices in a licensed facility or healthcare setting must be established at the practice level, subject to certain requirements specified in the full text of this bill;

(6) A facility or healthcare setting is not prohibited from requiring a physician assistant practicing within the facility or healthcare setting to practice pursuant to protocols. For purposes of this bill, "healthcare setting" means an entity organized to deliver healthcare services in Tennessee that is not a licensed healthcare facility or physician assistant-owned healthcare setting; and

(7) A physician assistant may render emergency medical service in cases where immediate diagnosis and treatment are necessary to avoid disability or death. Under present law, a physician assistant may render emergency medical service only in accordance with guidelines previously established by the collaborating physician pending the arrival of a responsible physician in cases where immediate diagnosis and treatment are necessary to avoid disability or death.

Under this bill, a physician assistant with 6,000 or fewer hours of postgraduate clinical experience may only have an ownership interest in a healthcare setting in this state, provided it is a minority ownership interest and practice partners are licensed healthcare providers.

Subject to certain exceptions, this bill prohibits a physician assistant from doing the following:

(1) Utilizing a board-certified medical specialty designation in the physician assistant's title or title reference;

(2) Advertising as board-certified in a medical specialty;

(3) Claiming board certification in a medical specialty when credentialing with any licensed healthcare facility or health insurance entity; or

(4) Claiming board certification in a medical specialty when applying for insurance for healthcare liability coverage.

This bill revises the practices for collaboration between physicians and physician assistants, including practices concerning prescribing authority and the performance of invasive procedures.